“Some jobs are too important to multitask,” writes Dr. Sibert, who is an anesthesiologist in California. Medicine is one of them. “My patients can count on the fact that when I am at work, my full attention is with them, and the rest of the time — well, I do my best, and luckily I never set my sights on the award for ‘Mother of the Year.’ ”

In a piece titled “Don’t Quit This Day Job,” Dr. Sibert flips the traditional concern for parents in medicine — brutal hours, little control over schedule — and turns it into a concern for the profession itself. Things like flexible schedules, shorter hours and a “piece work” mentality — the kinds of things that life/work proponents consider victories — are bad for health care, she argues:

Today… increasing numbers of doctors — mostly women — decide to work part time or leave the profession. Since 2005 the part-time physician workforce has expanded by 62 percent, according to recent survey data from the American Medical Group Association, with nearly 4 in 10 female doctors between the ages of 35 and 44 reporting in 2010 that they worked part time.

This may seem like a personal decision, but it has serious consequences for patients and the public.

Medical education is supported by federal and state tax money both at the university level — student tuition doesn’t come close to covering the schools’ costs — and at the teaching hospitals where residents are trained. So if doctors aren’t making full use of their training, taxpayers are losing their investment. With a growing shortage of doctors in America, we can no longer afford to continue training doctors who don’t spend their careers in the full-time practice of medicine.

It isn’t fashionable (and certainly isn’t politically correct) to criticize “work-life balance” or part-time employment options. How can anyone deny people the right to change their minds about a career path and choose to spend more time with their families? I have great respect for stay-at-home parents, and I think it’s fine if journalists or chefs or lawyers choose to work part time or quit their jobs altogether. But it’s different for doctors. Someone needs to take care of the patients.

Dr. Sibert then goes on to fire off the ultimate fighting words in the life/work balance debate. Since women’s productivity in medicine does not match that of men (female doctors employed full time work 4.5 fewer hours each week, and female pediatricians are five times more likely to take extended leaves), women, she argues, should think twice about entering the field in the first place:

Students who aspire to go to medical school should think about the consequences if they decide to work part time or leave clinical medicine. It’s fair to ask them — women especially — to consider the conflicting demands that medicine and parenthood make before they accept (and deny to others) sought-after positions in medical school and residency. They must understand that medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve.

That argument is not new, of course. It has been made since women first entered the workforce to take jobs that had traditionally gone to men. “Why give a woman a job,” the thinking went, “when she will just quit to have babies?” And anticipation of that argument underpins most discussion of life/work balance. As in “step carefully because if mothers demand too much employers will just stop hiring women.”

I think that argument gets it backwards. The problem is not that workers — mostly women at this point — are demanding too much, but rather that professions are archaically structured. Also, that the push for change still comes mostly from women. The answer is neither to shut up, nor to buck up. The answer is to recalibrate the hours and expectations of professions so that they can be done by the “new worker” — not a man with a wife at home (which is the assumption of the old structures) but rather a mother or father with a working partner and responsibilities at home.

Yes, there are a handful of professions that are incompatible with flexibility. President of the United States comes to mind (though at the moment he is doing a pretty good job of balancing.) And no, you don’t want your surgeon clocking out in the middle of your surgery. But that surgeon can structure a working life where she has more partners with which to share the schedule, so that while her days might be long, they are more predictable.

Just because things have always been done a certain way does not mean that is the way things should be done. All those women working 4.5 fewer hours and taking longer leaves in medicine? Where Dr. Sibert sees slacking, I see a new norm. One that requires fewer hours of more workers, perhaps. One that is should be embraced by men and women.

After Dr. Sibert’s piece appeared, I heard from a number of you who connected her essay in “TORN” with the one on the Op-Ed page. In the Motherlode Book Club comments, for instance, MYOBMoms wrote:

In her Torn essay Sibert says “you will never be the perfect wife and mother and have a high-powered career at the same time,” and she goes on to describe the (im)balance she has struck in her own life as anesthesiologist and mother.

Sibert’s op-ed piece makes a broader argument that since women doctors in general are “less productive” than men because many of them either work part-time or take extended leave at some point in their career, women should “consider the conflicting demands that medicine and parenthood make before they accept (and deny to others) sought-after positions in medical school and residency.”

Intolerance toward women who are comfortable scaling back their ambition for a period of time in order to achieve balance in their lives does such a disservice for women everywhere. Taken to its extreme, Dr. Sibert’s position would bring us back to a time when medical school students were predominately men, and women with an interest in medicine went into nursing. Imagine how Dr. Sibert would react if stay-at-home mothers suggested that women who want to be successful in their chosen professions thought twice about whether they should have children. Is being a doctor more important than being a parent?

It’s so important for women to support each other and the choices that we make. All professions have people like Dr. Sibert who feel that women can only be successful on men’s terms, I sincerely hope that my 17-year-old daughter finds better role models in whatever career she chooses.

I received a similar e-mail from Kathleen Beekman, who describes herself as “a 39-year-old ‘part-time’ oncologist with 3 young children ages 18 mo to 7 and a husband who is a ‘full time’ hand surgeon” whose ability to manage depends on “a small cadre of helpers from the indefatigable nanny and college babysitter to my mother-in-law occasionally pitching in to keep everything smooth.” She writes:

I think Sibert is missing something. The movement of more women working and more women choosing to work part-time so that they have additional time for their families is not a failure of the women’s movement but an evolution that is both necessary for society and at its core, entirely about being a woman.

When women were first starting to apply for graduate degrees and top level management positions, they were not in a position to negotiate — they needed to prove that they could be just as good “as a man” so they postponed having children or didn’t have any at all, they put in long hours as they thought their male colleagues were doing, and of course, they were able to succeed to a degree.

I am proof of that b/c growing up, I didn’t know that gender discrimination was even something I should consider. When I applied to medical school in 1994, it never occurred to me that the boy sitting next to me in organic chemistry could be smarter or more successful than I was just because he was male (partly b/c I did sooo much better on the tests than he did). I was accepted at one of the top 10 medical schools in the country. I did my residency at one of the top 10 Internal Medicine residencies where I was chosen to be a chief medical resident for an additional year of training (three of out four us were women).

It really wasn’t until my 2nd year of fellowship at one of the nation’s top cancer centers that I experienced anything even close to gender discrimination — “Your mentor is upset that you’re fertile…” After my daughter was born, I panicked for a short period of time but I thought my way out of that panic by negotiating a position that was “80%”. When I did that, someone (a man) tried to give me sage advice, quietly closed the door and said “Don’t do it. You’ll be fodder for the department, and no one will take you seriously.” Of course, I thought about his advice but in the end, I had to be honest with myself and protect some time for my young family.

Five years later, I work part-time and see about 50-60 patients per week — this equates to about 40 hrs per week. I take equal call, am present at almost every tumor board and practice meeting and participate at a national level in committees for the American Society of Clinical Oncology. This is “part-time,” and I will always feel that I am not home enough and not at work enough but I feel that having some protected time for my family makes me a better doctor and a better parent. As a patient, I purposely look for women physicians with children who are part time. They are more patient, more fastidious and generally, I trust them more b/c I think this is a smart choice.

So, I wonder if Dr. Sibert would consider that perhaps the “old way” of working 110 hrs per week is simply just old. Many young men are asking their practices if they too can have a 4 day work week, have some dedicated time with their families, and be home for dinner some nights. Why does this have to mean that we are not committed to our patients? Why can’t it be interpreted that this is a generation of physicians who value balance and in fact, that may make for a better doctor. Doctor shortages are constantly being predicted and if it is true that there is shortage then perhaps it has more to do with unrealistic (and potentially unsafe) expectations on the current workforce, regardless of whether they are “part-time”.

My final thought: Women need to stop apologizing for wanting and needing to be with their kids in addition to fulfilling their careers and playing a role in society. This is the ultimate feminist movement.

What all these women have to say is both specific to the medical profession and universal to work in general. It is, in many ways, the theme of “TORN,” in that what tears parents right now is a function of a workplace model rather than something necessarily endemic to being a parent.

About

We're all living the family dynamic, as parents, as children, as siblings, uncles and aunts. At Motherlode, lead writer and editor KJ Dell’Antonia invites contributors and commenters to explore how our families affect our lives, and how the news affects our families—and all families. Join us to talk about education, child care, mealtime, sports, technology, the work-family balance and much more